The long-term patency and fracture rates of stents placed in the popliteal arteries in Chinese patients with chronic critical limb ischemia or lifestyle-limiting claudication
10.3760/cma.j.issn.1008-1372.2017.12.004
- VernacularTitle:支架置入术治疗腘动脉闭塞性病变的中长期随访分析
- Author:
Shijun CUI
1
;
Lianrui GUO
;
Lixing QI
;
Zhu TONG
;
Jianming GUO
;
Yongquan GU
Author Information
1. 100053 北京,首都医科大学宣武医院血管外科,首都医科大学血管外科研究所
- Keywords:
Stents;
Arterial occlusive diseases/SU;
Popliteal artery/PA/SU;
Follow-up studies
- From:
Journal of Chinese Physician
2017;19(12):1772-1775
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate efficacy, safety, and long-term patency and fracture rates of self-expanding nitinol stent after failed percutaneous transluminal angioplasty ( PTA) of popliteal artery in patients with chronic critical limb ischemia ( CLI ) or lifestyle-limiting claudication in Chinese patients. Methods A total of 64 patients (68 limbs) was retrospectively analyzed who underwent endovascular treat-ment for stenoocclusive lesions in the popliteal artery from January 2008 to July 2012. In a single-center study, self-expanding nitinol stents were implanted in 68 popliteal arteries for the treatment of stenosis grea-ter than 75％ or occlusions in the popliteal arteries. Follow-up patency was assessed by clinical examina-tion, ankle-brachial index, and color ultrasound or digital subtraction angiography, and stent fracture was assessed by plain X-rays at 6 and 12 months and annually thereafter. Results Stent implantation was suc-cessful in 63 patients (98. 5％). Mean follow-up was 22. 1 months (22. 1 ± 13. 8). 1-year, 2-year and 3-year primary patency rate ( PPR) was 76％, 60％ and 43％, respectively. The 1-year, 2-year, and 3-year secondary patency rate ( SPR) was 87％, 82％ and 73％, respectively. The 1-year , 2-year, and 3-year PPRs and SPRs for subgroups, trans-articular surface versus no trans-articular surface were not significant difference (P>0. 05). Two patients were lost to follow-up (3％). Two patients (3％) died during the fol-low-up period. Stent fractures were seen in 11 limbs (11 of 68, 16. 2％) and the fractures were identified in P1 and P2 segment. Three patients were performed above-knee amputation because of stent occlusion and gangrene of limb (3 of 68, 4. 4％). Conclusions Stent implantation is a safe and effective treatment of popliteal artery occlusion. One can improve the popliteal arterial stent patency rate by interventional tech-nique, such as transcatheter arterial thrombolysis, balloon angioplasty, silverhawk atherectomy, and rescue stent. One maybe try to avoid stent placement up to the popliteal arterial P1 and P2 segment owing to stent fracture.
